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NPI Code Detail

MEDICARE: MICHAEL OJEDA PHYSICIAN ASSISTANT

MEDICARE: MICHAEL OJEDA PHYSICIAN ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1497614382
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL OJEDA PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 1731 E 120TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90059-3051
Country : US
Telephone Number : 323-563-4800
Fax Number :
Provider Business Practice Location Address
First Line : 1731 E 120TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90059-3051
Country : US
Telephone Number : 323-563-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2026
Last Update Date : 01/19/2026

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